Tailor's bunion is as an acquired lesion that causes chronic pain and swelling over the outer aspect of the distal foot. It is also known as a bunionette and is characterized by a painful prominence on the outer aspect of the foot in the area of the fifth metatarsal head.
These types of lesions were often seen on tailors with a cross-legged sitting posture. The posture resulted in pressure being placed on the lateral side of the foot.
Causes
Extrinsic causes - Commonly chronic
- Tailors' posture
- Footwear
Intrinsic causes
Structural Abnormalities
- Lateral bowing of the metatarsal shaft
- Enlargement of the metatarsal head
- Congenital splayfoot
Presentation
- Symptoms - Painful keratoses on the outer, bottom, or top aspect of the metatarsal head.
Imaging Studies
- Weight-bearing x rays of both feet
- Vascular studies are important with patients who have questionable circulation
Treatment
Conservative
- Padding
- Shoe modification
- Orthotic devices
- Anti-inflammatory medications
- Corticosteroid injections
Surgical Treatment
- Can be treated with simple removal of osseous bump when there is no evidence of anglular deformity
- With an angular deformity or a deviation in the bone is present an osteotomy (cut in the bone) is made and held together with a screw. The level of bone cut varies with the level of the deformity.
Possible Complications
- Malunion- Incomplete union or union in a faulty position
- Nonunion- A nonunion occurs when a broken bone does not heal
- Nerve Injury
- Joint pain and stiffness
- Symptomatic hardware
- Infection
- Recurrence
No comments:
Post a Comment